The effects of repeated amphetamine exposure on multiple measures of human behavior

Subjective effects of modafinil, a new central adrenergic stimulant in healthy volunteers: a comparison with amphetamine, caffeine and placebo

The subjective, behavioral and physiological effects of modafinil (300 mg PO) a new central adrenergic stimulant, were compared with those of dextroamphetamine (15 mg PO), caffeine (300 mg PO) and placebo in a randomized double-blind cross-over study. Sixteen healthy volunteers participated in the study y: 8 males and 8 females with no history of drug abuse and moderate use of caffeine. Subjective and behavioral effects were studied using the Addiction Research Center Inventory (ARCI), Profile of Mood States (POMS) and Visual Analog Scales before and 1, 2, 4 and 8 h post single oral dosing. Results showed that subjective effects of modafinil (300 mg) differed markedly from those of dextroamphetamine (15 mg). They were close to those produced by caffeine (300 mg). These results indicate that modafinil (300 mg) does not possess amphetamine-like subjective effects in a healthy population. If subjective feelings are related to drug abuse liability, it could be assumed that modafinil, at the dose used in therapeutics, does not possess any abuse liability comparable to amphetamine.

Assessment of tolerance to the effects of methamphetamine on daytime and nighttime activity evaluated with actigraphy in rhesus monkeys

RATIONALE

Methamphetamine is one of the most largely consumed illicit drugs, and its use is associated with abuse liability and several adverse health effects, such as sleep impairment. Importantly, sleep quality can influence addiction treatment outcomes. Evidence suggests that tolerance can develop to the sleep-disrupting effects of stimulant drugs.

OBJECTIVE

The aim of the present study was to investigate the development of tolerance to the actigraphy-based sleep-disrupting and stimulant effects of methamphetamine self-administration in rhesus monkeys.

METHODS

Methamphetamine (0.03 mg/kg/inf, i.v.) self-administration was carried out following three different protocols: 14 consecutive days of self-administration, 5 days/week for 3 weeks, with a 2-day interval between 5-day blocks of self-administration, and 3 days/week for 3 weeks, with a 4-day interval between 3-day blocks of self-administration. Daytime activity and activity-based sleep measures were evaluated with Actiwatch monitors a week before (baseline parameters) and throughout each protocol.

RESULTS

Methamphetamine self-administration markedly disrupted sleep-like measures and increased daytime activity. Tolerance developed to those effects with repeated methamphetamine intake exceeding five consecutive days. Inclusion of washout periods (2 or 4 days) between blocks of methamphetamine self-administration attenuated the development of tolerance, with longer breaks from methamphetamine intake being more effective in maintaining the sleep-disrupting and stimulant effects of methamphetamine.

CONCLUSIONS

Tolerance can develop to the stimulant and sleep-disrupting effects of methamphetamine self-administration. Interruption of drug intake extends the effects of methamphetamine on sleep-like measures and daytime activity.

Association between travel length and drug use among Brazilian truck drivers

OBJECTIVE

To investigate whether the use of the stimulants amphetamines and cocaine by truck drivers in Brazil was related to travel length.

METHODS

Truck drivers were randomly stopped by the Federal Highway Police on interstate roads in Sao Paulo State during morning hours from 2008 to 2011 and invited to participate in the project "Comandos de Saúde nas Rodovias" (Health Commands on the Roads). Participants were asked about the use of drugs, travel distance, and age, and gender was recorded. Samples of urine were collected and analyzed for amphetamine, benzoylecgonine (a metabolite of cocaine), and carboxytetrahydrocannabinol (THC-COOH; a metabolite of cannabis) by immunological screening and quantification by gas chromatography-mass spectroscopy.

RESULTS

Current use of amphetamine, cocaine, and cannabis was reported by 5.7%, 0.7%, and 0.3% of the truck drivers, respectively. Amphetamine, benzoylecgonine, and THC-COOH were found in urine samples from 5.4%, 2.6,% and in 1.0% of the drivers, respectively. There was a significant association between the positive cases for amphetamine and reported travel length; 9.9% of urine samples from drivers who reported travel length of more than 270 km were positive for amphetamine, and 10.9% of those drivers reported current use of amphetamines. In most cases, appetite suppressants containing amphetamines had been used, but the purpose was most often to stay awake and alert while driving. Truck drivers with travel length of more than 270 km had significantly higher odds ratio (OR) for having a urine sample that was positive for amphetamine when adjusted for age as confounding factor (OR = 9.41, 95% confidence interval [CI], 3.97-22.26). No significant association was found between the use of cocaine or cannabis and travel length.

CONCLUSION

Truck drivers who reported driving more than 270 km had significantly higher frequencies of urine samples positive for amphetamine and reported significantly more frequent current use of amphetamines than those who reported shorter driving distances.

Evaluation of the effects of anti-motion sickness drugs on subjective sleepiness and cognitive performance of healthy males

This study aimed to investigate the clinical and cognitive side effects of baclofen (10 mg), meclizine (25 mg), dimenhydrinate (40 mg) plus cinnarizine (25 mg) and promethazine (25 mg) plus d-amphetamine (10 mg). The study had a double-blind, placebo controlled, repeated measures design and was conducted on healthy male volunteers. The psychomotor vigilance test, the Sternberg working memory task, the implicit memory test and the automated Operation Span (Ospan) task were performed. The Stanford, the Karolinska and the Epworth Sleepiness scale determined the degree of sleepiness. The Profile of Mood States (POMS) evaluated mood states and adverse effects were reported on a 22-item questionnaire. Letter recalls and time for solving mathematical problems, recorded during the Ospan task, were impaired by baclofen and dimenhydrinate-cinnarizine respectively, suggesting an influence of these drugs on the working memory. Significant side effects for baclofen were: sleepiness, tiredness, blurred vision, concentration problems and dizziness whereas for dimenhydrinate-cinnarizine only sleepiness and blurred vision were reported. Meclizine decreased the accuracy on the Sternberg working memory task and thus seemed to affect short-term memory. A reported side effect was increased sleepiness. Promethazine plus d-amphetamine did not affect any of the tested cognitive functions. However, many side effects such as sleepiness, dry mouth, dizziness, vertigo, confusion, insomnia and tremors were reported. The results show that meclizine and dimenhydrinate combined with cinnarizine were the two drugs with the most acceptable combination of side effects.

Striatal ups and downs: their roles in vulnerability to addictions in humans

Susceptibility to addictive behaviors has been related to both increases and decreases in striatal function. Both profiles have been reported in humans as well as in animal models. Yet, the mechanisms underlying these opposing effects and the manner in which they relate to the behavioral development and expression of addiction remain unclear. In the present review of human studies, we describe a number of factors that could influence whether striatal hyper- or hypo-function is observed and propose a model that integrates the influence of these opposite responses on the expression of addiction related behaviors. Central to this model is the role played by the presence versus absence of addiction related cues and their ability to regulate responding to abused drugs and other rewards. Striatal function and incentive motivational states are increased in the presence of these cues and decreased in their absence. Alternations between these states might account for the progressive narrowing of interests as addictions develop and point to relevant processes to target in treatment.

The effects of amphetamine injections on feeding behavior and the brain expression of orexin, CART, tyrosine hydroxylase (TH) and thyrotropin releasing hormone (TRH) in goldfish (Carassius auratus)

In this study, the effects of peripheral (intraperitoneal) injections of D-amphetamine on feeding behavior were assessed in goldfish. Compared with the saline-injected group, amphetamine injections decreased food intake at doses ranging from 1 to 75 μg/g, but not 0.5 μg/g, but increased locomotor behavior, as indicated by the increased number of total feeding and non-feeding acts, at doses ranging from 2.5 to 25 μg/g. Amphetamine at high doses inhibited both food intake (at 25, 50 and 75 μg/g) and feeding behavior (at 75 μg/g). In the hypothalamus, the expression of orexin was down-regulated, and both CART 1 and CART 2 expressions were up-regulated in amphetamine-treated fish (50 μg/g) as compared to saline-injected fish, but amphetamine treatment had no effect on either hypothalamic TH or TRH expression. In the telencephalon, amphetamine treatment (50 μg/g) up-regulated CART 1, CART 2 and TH mRNA expressions but had no effect on either orexin or TRH. Our results suggest that, as in mammals, the orexin, CART and TH systems might be involved in amphetamine-induced feeding/locomotor responses in goldfish.

Dopamine and training-related working-memory improvement

Converging evidence indicates that the neurotransmitter dopamine (DA) is implicated in working-memory (WM) functioning and that WM is trainable. We review recent work suggesting that DA is critically involved in the ability to benefit from WM interventions. Functional MRI studies reveal increased striatal BOLD activity following certain forms of WM interventions, such as updating training. Increased striatal BOLD activity has also been linked to transfer of learning to non-trained WM tasks, suggesting a neural signature of transfer. The striatal BOLD signal is partly determined by DA activity. Consistent with this assertion, PET research demonstrates increased striatal DA release during updating of information in WM after training. Genetic studies indicate larger increases in WM performance post training for those who carry advantageous alleles of DA-relevant genes. These patterns of results corroborate the role of DA in WM improvement. Future research avenues include: (a) neuromodulatory correlates of transfer; (b) the potential of WM training to enhance DA release in older adults; (c) comparisons among different WM processes (i.e., updating, switching, inhibition) regarding regional patterns of training-related DA release; and (d) gene-gene interactions in relation to training-related WM gains.

Driving on ice: impaired driving skills in current methamphetamine users

RATIONALE

Previous research indicates a complex link between methamphetamine (METH) and driving performance. Acute dosing with amphetamines has improved driving-related performance in some laboratory studies, while epidemiological studies suggest an association between METH use, impaired driving, and accident culpability.

METHODS

Current METH users were compared to a control group of nonusers on driving simulator performance. Groups were matched for age, gender, and driving experience. Subjects were assessed for current drug use, drug dependence, and drug levels in saliva/blood as well as personality variables, sleepiness, and driving performance.

RESULTS

METH users, most of whom met the criteria for METH dependence, were significantly more likely to speed and to weave from side to side when driving. They also left less distance between their vehicle and oncoming vehicles when making a right-hand turn. This risky driving was not associated with current blood levels of METH or its principal metabolite, amphetamine, which varied widely within the METH group. Other drugs were detected (principally low levels of THC or MDMA) in some METH users, but at levels that were unlikely to impair driving performance. There were higher levels of impulsivity and antisocial personality disorder in the METH-using cohort.

CONCLUSIONS

These findings confirm indications from epidemiological studies of an association between METH use and impaired driving ability and provide a platform for future research to further explore the factors contributing to increased accident risk in this population.

Comparison of the behavioral and cardiovascular effects of intranasal and oral d-amphetamine in healthy human subjects

Recent reports indicate an increase in intranasal use of prescription oral stimulant medication. However, there do not appear to be any published clinical studies that have characterized the behavioral and cardiovascular effects of intranasally administered d-amphetamine, which is commonly prescribed for Attention Deficit Hyperactivity Disorder. In this study, a range of d-amphetamine doses (0, 16, 24, and 32 mg/70 kg) were administered as an intranasal solution delivered using a mucosal atomization device. Equal oral doses were included for comparison. Assessments were conducted before and at regular intervals for 3 hours following drug administration and included self-reported drug-effect questionnaires, cardiovascular indices, a performance task, and 2 measures of impulsivity. d-Amphetamine produced prototypical stimulant effects (eg, increased subject ratings of Stimulated and Like Drug, elevated heart rate and blood pressure, and improved rate and accuracy on the digit symbol substitution task) irrespective of dose, but the onset of these effects was generally earlier following intranasal administration, with significant effects emerging 15 to 30 minutes after intranasal dosing and 45 to 60 minutes after oral dosing. These results demonstrate that intranasal administration of d-amphetamine results in a more rapid onset compared to oral dosing, which could be associated with the popularity of intranasal prescription stimulant use and an enhanced potential for abuse.

Effect of an acute d-amphetamine administration on context information memory in healthy volunteers: evidence from a source memory task

RATIONALE

Previous research demonstrated a positive effect of d-amphetamine on long-term verbal memory. An improvement in memory for contextual information is proposed as a possible mechanism underlying the d-amphetamine facilitation effect.

OBJECTIVES

A double blind, placebo controlled experiment was used to examine the processes involved in episodic memory affected by an acute administration of d-amphetamine. We investigated whether positive effects of d-amphetamine on item memory could be extended to context information by using a source memory paradigm.

METHODS

In a within-subjects design with two sessions, two study lists were presented in each session and participants were required to make an old/new recognition decision (item memory) and a list discrimination judgement (source memory) after delays of 1 h, 1 day and 1 week.

RESULTS

Enhancement of item memory after d-amphetamine intake was observed on delayed tests only, confirming that amphetamine does not affect short-term memory or memory acquisition, but rather a process operating after initial encoding. Importantly, we found an enhancement in remembering the source of recognized items after d-amphetamine administration.

CONCLUSION

The present study suggests that an acute administration of d-amphetamine helps to bind different features of an item in memory, in turn leading to an increased ability to recollect both the item and its context.

Sensitization processes in drug addiction

In 1993, Robinson and Berridge published their first review that laid out the incentive sensitization theory of addiction (Robinson and Berridge 1993 Brain Res Rev 18:247). Its basic point is that repeated exposure to drugs of abuse causes hypersensitivity to drugs and drug-associated stimuli of the neural circuits mediating incentive salience, an important way in which motivational stimuli influence behavior. In laymen's terms, it states that this drug-induced hypersensitivity of motivational circuitry would mediate an increase in drug "wanting," thus being responsible for the dramatically exaggerated motivation for drugs displayed by addicts. This theory has been exceptionally influential, as evidenced by the fact that the original review paper about this theory (Robinson and Berridge 1993 Brain Res Rev 18:247) has been cited 2,277 times so far, and subsequent updates of this view (Robinson and Berridge 2000 Addiction 95(Suppl 2):S91; Robinson and Berridge 2001 Addiction 96:103; Robinson and Berridge 2003 Ann Rev Psychol 54:25) have been cited 274, 297, and 365 times, respectively, adding up to more than 3,200 citations within 15 years. The present chapter aims to delineate the merits and limitations of the incentive sensitization view of addiction, and whether incentive sensitization occurs in humans. We conclude that since incentive sensitization most prominently occurs after the first few drug exposures, it may represent an important initial step in the addiction process. During the expression of full-blown addiction, characterized by loss of control over drug intake and use of large quantities of drugs, the expression of incentive sensitization may be transiently suppressed. However, detoxification and the gradual disappearance of tolerance and withdrawal symptoms may unmask sensitization, which could then play an important role in the high risk of relapse.

Dopamine-induced changes in neural network patterns supporting aversive conditioning

The aim of the present paper is to assess the effects of altered dopamine (DA) transmission on the functional connectivity among brain regions mediating aversive conditioning in humans. To this aim, we analyzed a previous published data set from a double-blind design combined with functional magnetic resonance imaging (fMRI) recordings in which healthy volunteers were randomly assigned to one of three drug groups: amphetamine (an indirect DA agonist), haloperidol (DA D2 receptor antagonist), and placebo. Participants were exposed to an aversive classical conditioning paradigm using cutaneous electrical stimulation as the unconditioned stimulus (US), and visual cues as the conditioned stimuli (CS) where one colour (CS+) was followed by the US in 33% of the trials and another colour (CS-) had no consequences. All participants reported awareness of stimulus contingencies. Group analysis of fMRI data revealed that the left ventral striatum (VS) and amygdala activated in response to the CS+ in all the three groups. Because of their activation patterns and documented involvement in aversive conditioning, both regions were used as seeds in the functional connectivity analysis. To constrain the functional networks obtained to relate to the conditioned response, we also correlated seed activity with the Galvanic Skin Response (GSR). In the placebo group, the right ventral tegmental area/substantia nigra (VTA/SN), bilateral caudate, right parahippocampal gyrus, left inferior parietal lobule (IPL), bilateral postcentral gyrus, bilateral middle frontal (BA 46), orbitofrontal, and ventromedial prefrontal cortices (PFC, BA 10/11) correlated with the VS and amygdala seeds in response to the CS+ compared to the CS-. Enhancing dopamine transmission via amphetamine was associated with reduced task differences and significant functional connectivity for both CS+ and CS- conditions between the left VS seed and regions modulated by DA, such as the left VTA/SN, right caudate, left amygdala, left middle frontal gyrus (BA 46), and bilateral ventromedial PFC (BA 10). Blocking dopamine transmission via haloperidol was associated with significant functional connectivity across an alternate network of regions including the left amygdala seed and the right insula, the left ACC (BA 24/32), bilateral IPL (BA 40), precuneus (BA 7), post-central gyrus, middle frontal gyrus (BA 46), and supplementary motor area (SMA, BA 6) to the CS+ versus the CS-. These data provide insight into the distinct effects of DA agents on the functional connectivity between striatal, limbic, and prefrontal areas.

Cocaine abuse and sensitization of striatal dopamine transmission: a critical review of the preclinical and clinical imaging literature

Much effort has been devoted in the preclinical addiction literature to understanding the phenomenon of sensitization, an enhanced dopaminergic response in the nucleus accumbens that occurs after repeated exposure to psychostimulant drugs. Although sensitization has been reported in preclinical studies, studies of sensitization in humans measuring behavioral and physiological responses have been mixed and inconclusive. However, imaging studies with positron emission tomography (PET) and single photon emission computed tomography (SPECT) using a stimulant challenge to induce dopamine (DA) release provide a unique opportunity to probe DA transmission in cocaine dependent human subjects. In contrast to the basic science literature that predicted sensitization, three independent cohorts have shown a blunted DA response, or the opposite of sensitization, in human cocaine dependent subjects. This article reviews the methodological differences between the preclinical and clinical PET studies that have investigated DA sensitization in order to address the discrepancy between the human and animal literature.

Conditioned cues and the expression of stimulant sensitization in animals and humans

Repeated intermittent exposure to psychostimulants can lead to long-lasting sensitization of the drugs' behavioral and biochemical effects. Such findings have figured importantly in recent theories of drug addiction proposing that sensitized nucleus accumbens (NAcc) dopamine (DA) overflow in particular acts in concert with other alterations in the neurochemistry of this nucleus to promote drug seeking and self-administration. Yet, experiments in rodents, non-human primates and humans have not always detected behavioral or biochemical sensitization following drug exposure, bringing into doubt the utility of this model. In an effort to reconcile apparent discrepancies in the literature, this review assesses conditions that might affect the expression of sensitization during testing. Specifically, the role played by conditioned cues is reviewed. A number of reports strongly support a potent and critical role for conditioned stimuli in the expression of sensitization. Findings suggest that stimuli associated either with the presence or absence of drug can respectively facilitate or inhibit sensitized responding. It is concluded that the presence or absence of such stimuli during testing for sensitization in animal and human studies could significantly affect the results obtained. It is necessary to consider this possibility especially when interpreting the results of studies that fail to observe sensitized responding.

The explicit learning of new names for known objects is improved by dexamphetamine

A randomised, double-blind, placebo-controlled, between subjects study design (N=37) was used to investigate the effects of dexamphetamine on explicit new name learning. Participants ingested 10mg of dexamphetamine or placebo daily over 5 consecutive mornings before learning new names for 50 familiar objects plus fillers. The dexamphetamine group recognised and recalled the new names more accurately than the placebo group over the 5 days and 1 month later. Word learning success was not associated with baseline neuropsychological performance, mood, cardiovascular arousal, or sustained attention. These results may have implications for the pharmacological treatment of acquired naming difficulties.

Conditioned and sensitized responses to stimulant drugs in humans

In animal models considerable evidence suggests that increased motivation to seek and ingest drugs of abuse are related to conditioned and sensitized activations of the mesolimbic dopamine (DA) system. Direct evidence for these phenomena in humans, though, is sparse. However, recent studies support the following. First, the acute administration of drugs of abuse across pharmacological classes increases extracellular DA levels within the human ventral striatum. Second, individual differences in the magnitude of this response correlate with rewarding effects of the drugs and the personality trait of novelty seeking. Third, transiently diminishing DA transmission in humans decreases drug craving, the propensity to preferentially respond to reward-paired stimuli, and the ability to sustain responding for future drug reward. Finally, very recent studies suggest that repeated exposure to stimulant drugs, either on the street or in the laboratory, can lead to conditioned and sensitized behavioral responses and DA release. In contrast to these findings, though, in individuals with a long history of substance abuse, drug-induced DA release is decreased. This diminished DA release could reflect two different phenomena. First, it is possible that drug withdrawal related decrements in DA cell function persist longer than previously suspected. Second, drug-paired stimuli may gain marked conditioned control over the release of DA and the expression of sensitization leading to reduced DA release when drug-related cues are absent. Based on these observations a two-factor hypothesis of the role of DA in drug abuse is proposed. In the presence of drug cues, conditioned and sensitized DA release would occur leading to focused drug-seeking behavior. In comparison, in the absence of drug-related stimuli DA function would be reduced, diminishing the ability of individuals to sustain goal-directed behavior and long-term objectives. This conditioned control of the expression of sensitized DA release could aggravate susceptibility to relapse, narrow the range of interests and perturb decision-making, accounting for a wide range of addiction related phenomena.

Interference with Smoking-Cessation Effects of Varenicline After Administration of Immediate-Release Amphetamine-Dextroamphetamine

An 18-year-old man with attention-deficit-hyperactivity disorder (ADHD) was prescribed varenicline for smoking cessation. He quit smoking after 1 week of therapy and remained smoke free for the next 17 days. During that time, he had also been taking amphetamine-dextroamphetamine (Adderall) on work days for his ADHD. Because his supply of amphetamine-dextroamphetamine was diminishing, he took only half (30 mg every morning) of his prescribed dosage from days 4-12 of varenicline therapy. He further reduced his dosage to 15 mg every morning on days 13 and 14 of varenicline therapy, and his supply of amphetamine-dextroamphetamine was depleted on day 15. On day 23 of varenicline therapy, he received and filled a new prescription for amphetamine-dextroamphetamine and resumed his prescribed dosage (30 mg twice/day). He began smoking again within 48 hours. Rechallenge with varenicline while the patient continued to receive amphetamine-dextroamphetamine yielded similar results. Data suggest that addition of amphetamine to varenicline may negate the partial agonism of varenicline, resulting in elimination of the smoking-cessation aid's benefits. Other potential mechanisms for the drug interaction may also exist. Thus, varenicline may not aid smoking cessation in patients undergoing treatment with amphetamine and amphetamine-like drugs.

Verbal memory performance improved via an acute administration of D-amphetamine

BACKGROUND

An improved long-term retention of verbal memory was observed after an acute D-amphetamine administration. It was proposed that D-amphetamine modulates consolidation, but a possible drug effect on retrieval could not be rejected.

OBJECTIVES

We want to provide additional support for the consolidation hypothesis, and investigate whether an influence on intervening retrieval can be refuted.

METHODS

Thirty-six male paid volunteers participated in a double blind, counterbalanced, placebo-controlled design in which the number of intermediate free recall tests was manipulated.

RESULTS

A significant D-amphetamine facilitation effect on recall performance emerged 1 h and 1 day after list learning. In line with the consolidation hypothesis, no effect was found on immediate tests. Importantly, the number of intermediate retrievals did not affect the magnitude of the drug effect, suggesting that the D-amphetamine facilitation effect is independent of retrieval.

CONCLUSION

The D-amphetamine facilitation effect on verbal memory does not involve a modulation of the initial encoding or short-term memory (STM) processes. Moreover, the drug does not enhance long-term retention by acting on intervening retrieval processes. The current findings are in line with the conjecture of an involvement of the consolidation process in the D-amphetamine facilitation effect on verbal memory in healthy humans.

Individual differences in drug abuse vulnerability: d-amphetamine and sensation-seeking status

RATIONALE

While the personality dimensions of novelty seeking and sensation seeking are associated with drug abuse vulnerability, the mechanisms associated with this vulnerability remain obscure.

OBJECTIVE

This study examined the behavioral effects of d-amphetamine in healthy volunteers scoring in the upper and lower quartiles based on age- and gender-adjusted population norms on the impulsive Sensation-Seeking Scale (SSS) of the Zuckerman-Kuhlman personality questionnaire (ZKPQ).

METHOD

Participants completed 7-day outpatient studies examining the subjective, performance, and cardiovascular effects of d-amphetamine (0, 7.5, and 15 mg/70 kg, p.o.) under double-blind conditions according to a randomized block design. Performance tasks included behavioral measures of impulsivity, including attention, inhibition, and risk-taking behavior.

RESULTS

No differences in baseline performance or d-amphetamine effects on measures of attention, inhibition, and risk-taking behavior were observed. High impulsive sensation seekers reported greater increases on several subjective report measures associated with drug abuse potential, including visual analog scales feel drug, like drug, and high.

CONCLUSIONS

Healthy adults scoring in the top quartile on the population of the impulsive SSS of the ZKPQ may be vulnerable to the abuse potential of d-amphetamine.

The acute effects of d-amphetamine and methamphetamine on attention and psychomotor performance

RATIONALE

It is not clear how the deleterious effects of amphetamines on driving performance are mediated in terms of select cognitive processes.

OBJECTIVES

The current three separate experiments assessed the acute effects of an oral dose of either 0.42-mg/kg d-amphetamine, d,l-methamphetamine and d-methamphetamine on driving-related cognitive functions in a total of 60 healthy non-fatigued adults.

MATERIALS AND METHODS

Three separate repeated measures counterbalanced, double-blind, placebo-controlled designs were employed in which 20 volunteers completed two treatment conditions, either d-amphetamine, d,l-methamphetamine or d-methamphetamine and placebo. Performance was assessed on a range of attentional, psychomotor and perceptual speed tasks.

RESULTS

Mean blood concentrations at 120-, 170- and 240-min postdrug administration were 83, 98 and 96 ng/ml, respectively, for d-amphetamine, 90, 95 and 105 ng/ml, respectively, for d,l-methamphetamine and 72, 67 and 59 ng/ml, respectively, for d-methamphetamine. The amphetamines, in general, improved various aspects of attention (Digit Vigilance, Digit Symbol Substitution Test and Movement Estimation Performance) with some evidence to suggest possible enhancement in psychomotor functioning (Tracking ability) and perceptual speed (Inspection Time).

CONCLUSIONS

The current series of studies primarily provides evidence of low-level amphetamine-related enhancement of function; however, it also provides evidence of less conservative movement estimation that might contribute to amphetamine-related road fatalities.

The correlative triad among aging, dopamine, and cognition: Current status and future prospects

The brain neuronal systems defined by the neurotransmitter dopamine (DA) have since long a recognized role in the regulation of motor functions. More recently, converging evidence from patient studies, animal research, pharmacological intervention, and molecular genetics indicates that DA is critically implicated also in higher-order cognitive functioning. Many cognitive functions and multiple markers of striatal and extrastriatal DA systems decline across adulthood and aging. Research examining the correlative triad among adult age, DA, and cognition has found strong support for the view that age-related DA losses are associated with age-related cognitive deficits. Future research strategies for examining the DA-cognitive aging link include assessing (a) the generality/specificity of the effects; (b) the relationship between neuromodulation and functional brain activation; and (c) the release of DA during actual task performance.

Acute and chronic continuous methamphetamine have different long-term behavioral and neurochemical consequences

We compared two different methamphetamine dosing regimens and found distinct long-term behavioral and neurochemical changes. Adult rats were treated with 1-day methamphetamine injection (3x5 mg/kg s.c., 3 h apart) or 7-day methamphetamine minipump (20 mg/kg/day s.c.). The minipump regimen models the sustained methamphetamine plasma levels in some human bingers whereas the 1-day regimen models a naive user overdose. On withdrawal days 7 and 28, rats were acutely challenged with cocaine to test for behavioral sensitization and subsequently sacrificed for caudate and accumbens dopamine tissue content. Other rats were analyzed on withdrawal days 3, 7 or 28 using voltammetry in caudate slices. On withdrawal days 7 and 28, the methamphetamine injection but not the minipump rats showed behavioral cross-sensitization to cocaine. There was no change in baseline dopamine release, reuptake or sensitivity to quinpirole in any treatment group on either withdrawal day. However, consistent with the behavioral sensitization, cocaine had a greater effect in potentiating dopamine release and in blocking dopamine reuptake in methamphetamine injection versus saline irrespective of withdrawal day. The minipump group showed tolerance to the dopamine releasing effect of cocaine on withdrawal day 28 and had lower dopamine tissue content in the caudate versus the methamphetamine injection group. Dopamine turnover as measured by the DOPAC/dopamine ratio tended to be higher in the minipump-treated rats. These data suggest that the behavioral cross-sensitization seen in the methamphetamine injection rats could be in part due to the increased potency of cocaine in blocking dopamine reuptake and in increasing dopamine release. The decreased potency of cocaine in the caudate slices from the minipump-treated group may be related to decreased dopamine tissue content.

Neurobehavioral evaluation for a community with chronic exposure to hydrogen sulfide gas

In May 2000, the Agency for Toxic Substances and Disease Registry of the US government conducted a health investigation in response to community concerns regarding ambient and indoor hydrogen sulfide (H(2)S), odor, and health symptoms in Dakota City, Nebraska. The objective was to determine whether adult residents in an area with repeated exposure to H(2)S showed poorer performance on neurobehavioral tests than unexposed residents. Study participants were required to meet age (#10878;16 years of age) and length of residency (2 years) eligibility requirements. A battery of computer-assisted standardized neurobehavioral tests was administered in English or Spanish. A questionnaire was used to collect information about participants, demographic and health status. Three hundred forty-five people agreed to participate. After the exclusion of 10 persons, analyses were conducted on 335 participants; 171 residents in the target area and 164 residents in the comparison area. The two groups were comparable in demographic characteristics and various health conditions. Overall, neurobehavioral test results for the target and comparison groups were similar. Residence in the H(2)S-exposed area was associated with marginally poorer performance on a test of memory, namely, match to sample score, and a test of grip strength. However, these differences were not significant. Deficits in overall neurobehavioral performance were not associated with exposure to H(2)S in this study.

Sensitization to the cardiovascular but not subject-rated effects of oral cocaine in humans

BACKGROUND

Despite a substantial nonhuman literature in the area, few studies have experimentally evaluated the effects of repeated stimulant administration in human participants. This study examined the effects of repeated cocaine in individuals with histories of abuse and dependence.

METHODS

Twenty-two individuals with recent histories of cocaine abuse received under double-blind conditions, in pseudorandom order, four administrations of oral cocaine (150 mg [n = 14] or 200 mg [n = 8]) and two administrations of placebo. All administrations were given on separate days. Cardiovascular measures were collected and included heart rate, systolic pressure, diastolic pressure, mean arterial pressure, and pressure rate product. Subject-rated effects were assessed using the Addiction Research Center Inventory (ARCI) and a 15-item drug-effect questionnaire.

RESULTS

There were significant differences between placebo days and cocaine days in both cardiovascular and subject-rated effects. Moreover, three of five cardiovascular measures analyzed revealed a significant main effect for day of cocaine administration. A planned follow-up contrast revealed a significant increasing linear trend for each of these variables across days. No significant effects were found for day of administration for the subject-rated items.

CONCLUSIONS

These results indicate that, under controlled laboratory conditions, repeated oral cocaine administration may result in sensitization to the cardiovascular effects, but not subject-rated effects.

Effect of nonnicotine pharmacotherapy on smoking behavior

Smoking-related disease is the single biggest preventable cause of morbidity and mortality in the United States, yet approximately 25% of Americans continue to smoke. Various dosage forms of nicotine replacement therapy increase smoking quit rates relative to placebo, but they generally do not result in 1-year quit rates of over 20%. To increase these rates, a number of nonnicotine agents have been investigated. Drugs that modulate noradrenergic neurotransmission (bupropion, nortriptyline, moclobemide) are more effective than those affecting serotonin (selective serotonin reuptake inhibitors, buspirone, ondansetron) or other neurotransmitters.

Within- and between-subject variability in the reinforcing and subjective effects of nitrous oxide in healthy volunteers

Within- and between-subject variability in the reinforcing and subjective effects of nitrous oxide (N(2)O) was studied across five sessions. Twelve volunteers with no history of drug dependence sampled 30% N(2)O and 100% oxygen for 10 min each, then chose nine times, once every 5 min, among N(2)O (e.g. "Agent A"), oxygen (e.g. "Agent B"), or "drug-free air." Choice varied across subjects but was stable within subjects. Quantitative differences in subjective effects occurred within and across subjects. Some subjective effects were correlated with choice and/or differed between subjects who were consistent choosers of N(2)O versus those who were not. However, drug liking and euphoria, two face-valid measures of abuse liability, were unrelated to choice. Thus, the present study found individual differences (i.e. between-subject variability) in subjective and reinforcing effects of N(2)O and, in terms of within-subject variability, suggested that subjective effects fluctuate across sessions to a relatively greater extent than do reinforcing effects. The varying degrees of correlation between N(2)O choice and its subjective effects emphasize the need for obtaining multiple measures when characterizing abuse liability of this drug.

Methods to identify and characterize developmental neurotoxicity for human health risk assessment. I: behavioral effects

Alterations in nervous system function after exposure to a developmental neurotoxicant may be identified and characterized using neurobehavioral methods. A number of methods can evaluate alterations in sensory, motor, and cognitive functions in laboratory animals exposed to toxicants during nervous system development. Fundamental issues underlying proper use and interpretation of these methods include a) consideration of the scientific goal in experimental design, b) selection of an appropriate animal model, c) expertise of the investigator, d) adequate statistical analysis, and e) proper data interpretation. Strengths and weaknesses of the assessment methods include sensitivity, selectivity, practicality, and variability. Research could improve current behavioral methods by providing a better understanding of the relationship between alterations in motor function and changes in the underlying structure of these systems. Research is also needed to develop simple and sensitive assays for use in screening assessments of sensory and cognitive function. Assessment methods are being developed to examine other nervous system functions, including social behavior, autonomic processes, and biologic rhythms. Social behaviors are modified by many classes of developmental neurotoxicants and hormonally active compounds that may act either through neuroendocrine mechanisms or by directly influencing brain morphology or neurochemistry. Autonomic and thermoregulatory functions have been the province of physiologists and neurobiologists rather than toxicologists, but this may change as developmental neurotoxicology progresses and toxicologists apply techniques developed by other disciplines to examine changes in function after toxicant exposure.

Sensitization of anorexia and locomotion induced by chronic administration of ephedrine in rats

Repeated daily administration of the sympathomimetic agent ephedrine (EPH) leads to an augmentation (sensitization) of locomotor activity in rats. The present experiments examined the impact of repeated administration of the (-)- and (+)-EPH enantiomers on feeding in rats to assess whether the anorexic activity of EPH exhibits tolerance or sensitization during chronic exposure and whether the time course of these effects follows that observed in studies of locomotion. Adult male rats were injected once daily for 12 days with either vehicle or 5, 10 or 20 mg/kg (-)-EPH or with 10 or 20 mg/kg (+)-EPH. Horizontal locomotion and diet consumption were assessed for 60 min in an activity chamber. Suppression of feeding and the induction of locomotion were augmented over the first four days of administration of either 10 mg/kg or 20 mg/kg of the (-)-EPH enantiomer. In contrast, repeated administration of 20 mg/kg (+)-EPH resulted in augmentation of appetite suppression but not locomotion. These results confirm and extend the phenomenon of locomotor and feeding sensitization for ephedrine, but suggest that these effects may differ for the two enantiomers of ephedrine.

Dopamine and the mechanisms of cognition: Part II. D-amphetamine effects in human subjects performing a selective attention task

BACKGROUND

A neural network computer model described in a companion paper predicted the effects of increased dopamine transmission on selective attention under two different hypotheses.

METHODS

To evaluate these predictions we conducted an empirical study in human subjects of D-amphetamine effects on performance of the Eriksen response competition task. Ten healthy volunteers were tested before and after placebo or D-amphetamine in a double-blind cross-over design.

RESULTS

D-amphetamine induced a speeding of reaction time overall and an improvement of accuracy at fast reaction times but only in the task condition requiring selective attention.

CONCLUSIONS

This pattern of results conforms to the prediction of the model under the hypothesis that D-amphetamine primarily affects dopamine transmission in cognitive rather than motor networks. This suggests that the principles embodied in parallel distributed processing models of task performance may be sufficient to predict and explain specific behavioral effects of some drug actions in the central nervous system.

Detection of the erect position in the freely-moving human: sensor characteristics, reliability, and validity

The present report systematically examined a means to electronically detect the erect position in the human in the natural setting. The detector was based on pressure changes in a glycerin filled tube attached to a subject's leg, and it unobtrusively and continuously measured the relative vertical distance between the hip and leg. Initial experiments established the reliability of the sensor system as a function of 1. different sizes of the tubing, 2. different amounts of air in the glycerin and 3. different ambient temperatures (6 degrees-32 degrees C). Then, in a laboratory study of normal adults, the detector was seen to discriminate sitting from standing and (when activity data were included) these two behaviors, in turn, from walking. The detector also accounted for significant differences in HR seen in the standing, as opposed to the sitting, position. In addition, when subjects carried the detector during their daily activities and provided information about their activities using an experience sampling procedure, sitting was discriminated from standing and walking with acceptable diagnostic characteristics. Thus, sitting was detected with a sensitivity of 86.1% (correct detection of all occasions when sitting actually occurred). a positive predictive value of 92.6% (occasions that the detector was right when it indicated sitting), and a negative predictive value of 80.7% (occasions that the detector was right when it indicated sitting). Finally, we demonstrated in two additional ways the direct benefit of our detector in behavioral studies in the natural environment. First, with the detector, we could confirm that a subject had performed simple activities and errands while not under close supervision. Second, cigarette smoking in the natural environment was shown to increase HR, but only when the subjects were sitting. It was concluded that our detector can be effectively applied to the identification of the sitting vs. the erect position in humans in the natural setting, and that this information may be necessary to interpret behavioral and physiological effects seen in such subjects.

Amphetamine self-administration by humans: modulation by contingencies associated with task performance

The effect of task performance feedback and associated monetary earnings on drug self-administration were evaluated using eight subjects in a residential laboratory setting. The hypothesis was that if subjects believed that d-amphetamine impaired performance and reduced monetary earnings, d-amphetamine self-administration would decrease. Subjects performed computer tasks every day: on certain days that they received capsules, subjects were given bogus feedback regarding their performance ("better" or "worse" than average). On sample days, subjects were required to take d-amphetamine (10 mg BID) or placebo (0 mg BID) capsules. On choice days, subjects could choose between either d-amphetamine or placebo. Subjects received feedback on their task performance on 2 sample days and 2 of 4 choice days. Subjects received no feedback on the remaining two choice days. When subjects received no feedback, they chose d-amphetamine over placebo 78% of the time, and when they were given better feedback messages, they chose d-amphetamine 87.5% of the time. In contrast, d-amphetamine self-administration decreased significantly to 25% when subjects were told that it impaired their performance on work tasks and resulted in reduced earnings. In reality, d-amphetamine had little effect on work task performance. However, compared to placebo, d-amphetamine significantly increased subjective ratings of "Stimulated" and "Good Drug Effect" and significantly decreased ratings of "Tired" and "Sleepy." These results demonstrate that d-amphetamine served as a reinforcer under conditions in which drug self-administration did not influence monetary earnings, but that d-amphetamine self-administration could be modified by feedback/monetary earnings. Thus, contingencies associated with performance have important implications for drug use in the workplace.

Effect of fenfluramine on food intake, mood, and performance of humans living in a residential laboratory

Five male and four female normal weight research volunteers, participating in 13-day residential studies, received oral fenfluramine (20, 40 mg) or placebo at 09:30 and 17:00. Food intake, performance, and subjective ratings were measured throughout the day. Carbohydrate intake was manipulated by providing lunch meals high (males: 120 g; females: 80 g) or low (males: 25 g; females: 16 g) in carbohydrate on 8 days; on the remaining days subjects self-selected lunch. Total caloric intake (approximately 2800 Kcal) did not differ among the low- and high-carbohydrate, and self-selected lunch conditions when subjects received placebo, indicating caloric compensation. Total carbohydrate intake was significantly less, however, when subjects consumed the low-carbohydrate lunch compared to the other lunch conditions. Fenfluramine significantly decreased total caloric intake (approximately 500 kcal) by decreasing meal size, not number, only when subjects consumed the low-carbohydrate lunch. Fenfluramine was only an effective anorectic drug when subjects consumed a lunch with fewer calories and a lower carbohydrate:protein ratio than self-selected baseline. Also, fenfluramine improved performance on a range of computer tasks and increased ratings of "Alert," "Friendly," and "Talkative," while decreasing ratings of "Tired" and "Irritable."

Effect of amphetamine on human macronutrient intake

Six male subjects participated in a 15-day residential study examining the effects of amphetamine on macronutrient intake. During the first 11 days, carbohydrate intake was manipulated by providing lunch meals high (155 g) or low (25 g) in carbohydrate. Subjects received oral d-amphetamine (5, 10 mg/70 kg, BID) or placebo. Total daily caloric intake was similar under both lunch conditions (approximately 3400/Kcal), but carbohydrate contributed more energy under the high-carbohydrate condition. Both doses of amphetamine decreased total caloric intake to approximately 2600 Kcal, by decreasing the number of eating bouts, without affecting macronutrient selection. During the last four days subjects received a higher daily dose of amphetamine (30 mg/70 kg in four doses) or placebo, and were allowed to self-select lunch. Although 30 mg amphetamine decreased intake of all macronutrients, the relative contribution of carbohydrate to total caloric intake was increased from 54% to 62%, while the contribution of fat was decreased from 32% to 26% and the contribution of protein was decreased from 14% to 12%. Thus, at a high dose, amphetamine altered the relative contribution of specific macronutrients to total caloric intake.

Behavioral response to diazepam in a residential laboratory

Two groups of three healthy adult male volunteers without histories of sedative or other drug abuse participated in 15-day residential studies. Each day consisted of a private work period (10 AM to 4:30 PM), during which subjects participated in traditional laboratory performance tasks, and a social period (5 to 11:30 PM), during which subjects had access to recreational activities available under social or private conditions. Tobacco cigarettes and food were available throughout each day (9 AM to 12 PM). Diazepam (5 or 10 mg/70 kg) or placebo was administered orally twice daily in alternating three-consecutive-day intervals. Dosing order varied between groups. Diazepam had no effect on the total amount of time subjects spent in social conditions; however, the low dose increased verbal interaction, while the high dose decreased verbal interaction. Both doses disrupted performance on a second-order repeated-acquisition task but produced no effects on the other performance measures. Five of six subjects increased caloric intake following at least one dose, with the largest increases observed in subjects with the lowest baseline intake. Increases in subject reports of dose "Potency" and "Sedated" were also observed following the high dose. Diazepam doses routinely used in clinical settings influenced a variety of behaviors that are observed in the natural ecology, but not performance on accepted laboratory tasks.